Junior Network Contract Manager - REMOTE

  • location: Minneapolis, MN
  • type: Contract
  • salary: $36.66 per hour
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job description

Junior Network Contract Manager - REMOTE

job summary:
Description

This will be a telecommuter opportunity that will focus on outpatient behavioral health provider recruitment and contracting for Medicaid, commercial and Medicare products. Position works on contract amendments; review and analyze and make recommendations regarding provider reimbursement increase requests; and investigates provider questions about existing contract. As appropriate, position investigates internal questions about provider contracts, rates and related matters.

Position will attend and as appropriate participate in webex conference calls regarding new products and markets, provider recruitment and expansion of outpatient behavioral health network in Western U.S.

The position will possibly involve some travel for provider recruitment. Most provider interaction will be telephonically or electronically through the docu-sign and salesforce applications.

Specific Duties:

1. Provider overall assistance in developing or expanding outpatient behavioral health provider network

2. Maintain documentation of provider recruitment effort in all applicable systems

3. Provider outreach follow-up for network development or expansion both telephonically and email

4. Provider contracting and contract amendments through provider interacting both telephonically, email and computer systems

5. Analyze provider fee schedules, analyze provider reimbursement increase requests and make recommendations

6. Manage services issues related to provider data updates following protocols

Specific Tasks

- Make follow up outreach via phone or email to network providers or prospective providers

- Document/entering data updates through the Salesforce application

- As an integral part of the recruitment efforts, review and process returned documents

- Collect all contracting and credentialing information from providers for credentialing purposes

- Submit applications/contracts/credentialing for processing

- Document with entering recruitment data updates through the Salesforce application

- Send contracting information to providers

- Submit provider updates through the ePuf application system following protocol

- Weekly follow up with provider related to needed information for provider recruitment

- Prepare provider contracts and amendments

- Send provider contracts for signature via Docusign

- Review and analyze provider reimbursement increase requests using Fiscal Analysis Tool spreadsheet and make recommendations to Western Region Director

Qualifications/Experience:

1. Assess and interpret customer needs and requirements with providers and staff

2. Ability to solve moderately complex problems and conduct moderately complex analysis

3. Perform work with minimal guidance to meet timelines

4. Experience working with behavioral health providers preferred

5. Min. undergraduate degree or equivalent

6. Prior health plan experience in provider contracting/provider relations

7. Experience using Microsoft Excel software

8. Experience and ability to analyze provider fee schedules and reimbursement for specific CPT codes quickly and thoroughly.

9. Experience in behavioral health contracting with health plan and/or provider organization

10. Understand health insurance provider contracting

11. Experience with Medicaid and commercial outpatient behavioral health contracting

- The ideal person would have a strong background in customer service and health insurance industry for team support

- The ideal qualities would include someone who is highly organized/able to multi-task/detail oriented/friendly personality who can instill confidence in providers to obtain their signatures

- Proactive, self-motivated

- Quick learner

- Comfortable learning to use multiple software platforms

- Team-player

- Respects chain of command

- Solid verbal and written communications skills

- Articulate on phone and conference calls

- Ability to work in a fast-paced environment with multiple-competing priorities

 
location: Minneapolis, Minnesota
job type: Contract
work hours: 8 to 5
education: Bachelor's degree
experience: 2 Years
 
responsibilities:
Specific Tasks

- Make follow up outreach via phone or email to network providers or prospective providers

- Document/entering data updates through the Salesforce application

- As an integral part of the recruitment efforts, review and process returned documents

- Collect all contracting and credentialing information from providers for credentialing purposes

- Submit applications/contracts/credentialing for processing

- Document with entering recruitment data updates through the Salesforce application

- Send contracting information to providers

- Submit provider updates through the ePuf application system following protocol

- Weekly follow up with provider related to needed information for provider recruitment

- Prepare provider contracts and amendments

- Send provider contracts for signature via Docusign

- Review and analyze provider reimbursement increase requests using Fiscal Analysis Tool spreadsheet and make recommendations to Western Region Director

 
qualifications:
Qualifications/Experience:

1. Assess and interpret customer needs and requirements with providers and staff

2. Ability to solve moderately complex problems and conduct moderately complex analysis

3. Perform work with minimal guidance to meet timelines

4. Experience working with behavioral health providers preferred

5. Min. undergraduate degree or equivalent

6. Prior health plan experience in provider contracting/provider relations

7. Experience using Microsoft Excel software

8. Experience and ability to analyze provider fee schedules and reimbursement for specific CPT codes quickly and thoroughly.

9. Experience in behavioral health contracting with health plan and/or provider organization

10. Understand health insurance provider contracting

11. Experience with Medicaid and commercial outpatient behavioral health contracting

- The ideal person would have a strong background in customer service and health insurance industry for team support

- The ideal qualities would include someone who is highly organized/able to multi-task/detail oriented/friendly personality who can instill confidence in providers to obtain their signatures

- Proactive, self-motivated

- Quick learner

- Comfortable learning to use multiple software platforms

- Team-player

- Respects chain of command

- Solid verbal and written communications skills

- Articulate on phone and conference calls

- Ability to work in a fast-paced environment with multiple-competing priorities

 
skills: Other
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

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